Surgical table and accessories to facilitate hip arthroscopy

This application is a continuation of U.S. patent application Ser. No. 17/811,862, filed Jul. 11, 2022, which is a continuation of U.S. patent application Ser. No. 15/579,409, filed Dec. 4, 2017, now U.S. Pat. No. 11,382,816, which is a U.S. national stage application under 35 USC 371 of International Application No. PCT/US2016/036090, filed Jun. 6, 2016, which claims the benefit of U.S. Provisional Application No. 62/171,891, filed Jun. 5, 2015, and U.S. Provisional Application No. 62/250,072, filed Nov. 3, 2015. The disclosures of these priority applications are hereby incorporated by reference in their entireties.

Various embodiments of the present technology generally relate to surgical tables and accessories. More specifically, some embodiments generally relate to surgical tables and accessories to facilitate hip arthroscopy.

Hip arthroscopy is a surgical procedure being used with increasing frequency as the understanding of arthroscopic management of groin pain improves. The diagnostic and therapeutic uses are numerous and most commonly directed at intraarticular cartilage and labral pathology. However, to access the hip joint arthroscopically, traction must be placed on the leg to allow the surgeon access to the hip joint. Hip arthroscopy can be performed in the supine or lateral position, typically with the leg in a boot and a padded post in the groin to act as countertraction. The padded post can be used to distract the femur from the acetabulum, or realign fractured fragments.

The use of the perineal post has resulted in a variety of complications. For example, complications related to traction may be related to the amount of pressure of the post on the groin and the length of time the pressure is applied. In many cases the surgery may last two or more hours. Examples of complications of traction attributed to the post include, but are not limited to, injury of tissues, nerves (e.g., perineal or pudendal neuropraxias), blood vessels and other structures in the groin area. Accordingly, reliable and consistent techniques and tools to reduce the potential for complications during hip arthroscopy are beneficial.

The headings provided herein are for convenience only and do not necessarily affect the scope or meaning of the claimed embodiments. Further, the drawings have not necessarily been drawn to scale. For example, the dimensions of some of the elements in the figures may be expanded or reduced to help improve the understanding of the embodiments. Moreover, while the disclosed technology is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the embodiments described. On the contrary, the embodiments are intended to cover all modifications, equivalents, and alternatives falling within the scope of the embodiments as defined by the appended claims.

The following description provides specific details for a thorough understanding and enabling description of these examples. One skilled in the relevant art will understand, however, that the techniques discussed herein may be practiced without many of these details. Likewise, one skilled in the relevant art will also understand that the technology can include many other features not described in detail herein. Additionally, some well-known structures or functions may not be shown or described in detail below so as to avoid unnecessarily obscuring the relevant description.

The terminology used below is to be interpreted in its broadest reasonable manner, even though it is being used in conjunction with a detailed description of some specific examples of the embodiments. Indeed, some terms may even be emphasized below; however, any terminology intended to be interpreted in any restricted manner will be overtly and specifically defined as such in this section.

Various embodiments of the present technology generally relate to surgical tables and accessories. More specifically, some embodiments generally relate to surgical tables and accessories to facilitate hip arthroscopy. Traditional techniques for performing distraction of the hip joint during arthroscopy, or while performing reduction of hip fractures, utilize a perineal post against which the pressure to distract the femur from the acetabulum, or realign the fractured fragments, is transferred. This pressure can, in some instances, fail to sufficiently protect tissues, nerves, blood vessels and other anatomical structures in the groin. As discussed below, various embodiments of a surgical table system in accordance with the present disclosure provide new devices and methods for performing hip distraction without the use of the perineal post, or with minimized pressure on the perineal post, if used.

1 FIG. In accordance with various embodiments, the distraction system may be attached to a surgical table along with a variety of accessories designed to facilitate hip distraction, hip fracture reduction and fixation, or anterior approach hip replacement procedures, with or without a perineal post.is an isometric view of a surgical table and accessories in accordance with one or more embodiments of the present technology.

1 FIG. 1 2 1 3 4 5 3 4 2 6 1 2 1 2 4 2 6 In the embodiment illustrated in, a distraction systemis attached to a surgical table. In some embodiments, the distraction systemcan include beams or armsconnected to basevia adjustable joints. The beamsand basecan be secured to surgical tablewith adjustable locking mechanismsto allow the distraction systemto modularly attach to a variety of surgical tables, including retrofit of distraction systemto pre-existing surgical tables. For example, in the illustrated embodiment, the tableincludes a table portion sized and configured to receive and support a patient and a pedestal foot sized to provide a stable support for the table portion. In other embodiments, basemay be integrally and/or monolithically formed as a part of the pedestal foot of table, obviating the need for a separate locking mechanism.

2 1 14 FIG. 1 FIG. In some embodiments, the tableis configured to allow the table portion to tilt relative to the pedestal foot, such that the plane of the patient support surface forms angle θ () with respect the pedestal foot (and the floor of the room in which systemis installed). Angle A, shown inas the angle between the patient support surface and the vertical axis of the stanchion linking the table portion with the pedestal foot, is complementary to angle θ (i.e., θ=90−A). Such tilting of the table portion may be used to position the head of the patient below the hip of the patient, e.g., in the Trendelenburg position, as further described below. For purposes of the present discussion, a positive value of angle θ corresponds to a Trendelenburg tilt in which the patient's head is lower than the patient's hip.

3 3 1 The beamsmay be solid or hollow in various embodiments. The beamsmay include one or more rounded transition points in some embodiments. In accordance with some embodiments, these components of distraction systemcan be made of various materials (e.g., aluminum, carbon fiber, etc.) to provide a balance between strength and light weight for moving,

6 4 2 1 6 6 4 5 4 4 2 Locking mechanismsmay be removable from baseto allow different locking mechanisms to be selected (e.g., to ensure compatibility between the configuration or model of surgical tableand the configuration of distraction system). In some embodiments, locking mechanismsmay include a bracket with an open end that allows the locking mechanismsto wrap around a portion (e.g., a foot or post) underneath the surgical table when slid along the elongated openings.in base. Other types of locking mechanisms may be used as long as the baseis securely attached to the surgical tableto prevent sliding or twisting.

1 5 8 5 3 5 5 3 3 5 8 The distraction systemcan have a variety of adjustable parts (e.g., adjustable jointsand adjustable posts) to accommodate patients with a variety of heights from short to tall. Adjustable jointsallow the beamsto be rotated about pivot shafts.(which define a generally vertical pivot axis) into a desired medial/lateral position. For example, the beamsmay be positioned far enough apart to allow for various medical equipment (e.g., imaging equipment) to be positioned between the beams. In addition, adjustable jointsand adjustable postscan enable disassembly of the unit for transport or storage.

8 9 9 8 Support posts or stanchionscan include locking castersto allow for angular adjustment (e.g., hip adduction and abduction). In accordance with some embodiments, locking castersmay be replaced (or supplemented) with other support mechanisms to prevent movement and lateral translation of the support posts. Examples of other support mechanisms include, but are not limited to extendable tri-pod like stands and extendable supports.

8 10 10 7 3 8 7 2 Support posts or stanchionscan include a gear boxto allow for vertical adjustment of equipment. Other embodiments may use a simple slide/clamp mechanism instead of the gear box. Locking linear slidesmay be used in some embodiments to couple the beamsto the posts. The locking linear slidemay be used to pull a boot, foot support or other distal patient restraint away from surgical tableto apply gross traction for distraction of the femur. In some embodiments, other suitable linear adjusters may be used. For example, linear adjustment mechanisms for applying traction may be used as described herein, including telescoping linear slides.

11 12 7 An upper support post with a mounthaving standard surgical table rail dimensions allows for attachment of any standard surgical table equipment (e.g., hip positioning systems such as padded boots, foot supports or other distal patient restraints). Additionally, a generic mountmay be present at the upper end of the support post for fixation of other equipment either custom or generic. Moreover, any support post arrangement, with a separately affixed or integral/monolithic patient restraint may be used in the present technology. As described herein, support posts may extend upwardly from linear slide(or other linear actuators as described herein), as well as downwardly therefrom in a variety of potential configurations.

13 2 13 14 15 2 14 FIG. Some embodiments of the present technology include table extensionthat allows for positioning of the patient on the distal end of the surgical table. In some embodiments, the table extensionis radiolucent to allow for radiographic imaging of the patient through the table extension. An optional perineal postmay be provided and designed to accommodate positioning for either right or left side procedures. In some embodiments, the distraction system does riot include a perineal post. Instead, the traction force is provided by a friction padand/or the tilt angle θ of the table, as seen inand explained more fully below.

2 FIG. 1 FIG. 13 13 13 16 17 14 16 13 16 13 18 13 18 2 13 18 13 2 18 With reference to, the table extensionmay be provided in different sizes that can be selected based on the size of the patient, with larger sizes used for larger patients in order to provide for a larger support surface area and greater frictional interaction between the patient and the support surface of extension. Also, some embodiments of the table extensioncan include an elongated aperturein which a supporting extensionof the perineal postcan be optionally attached as desired by a surgeon. The elongated apertureallows the perineal post to be laterally positioned depending upon the operating leg of the patient. Other embodiments (not shown), may include two or more apertures which provide a series of fixed positions for the optional perineal post. Still yet, some embodiments of table extensionmay not allow for a perineal post to be attached, or may not have a perineal post installed in aperture. The table extensioncan include an adjustable attachment mechanismthat can be used to secure the table extensionto surgical tables of different widths (e.g., nineteen inches, twenty inches, etc.). In the illustrated embodiment, attachment mechanismincludes a pair of attachment arms engaged (e.g., frictionally) with the lateral surfaces of the table portion of surgical table(as shown in) in order to fix table extensionto the distal end of the adjacent patient support surface. Of course, it is contemplated that any suitable attachment mechanismmay be used for such fixation, including fasteners, adhesives, or the like. In some embodiments, table extensionmay be integrally and/or monolithically formed as a part of the table portion of surgical table, obviating the need for a separate attachment mechanism.

15 13 15 A friction padcan be mounted to an upper surface of extension, and can be used in conjunction with the weight of the supported patient to generate forces opposing the distraction force. In combination with the tilt angle θ (e.g., Trendelenburg tilt) of the table, the frictional forces created by friction padmay negate or minimize the need for a counter-traction perineal post. In some embodiments, the addition of a side-tilt of less than 2 degrees (e.g., 0.5 to 2.0 degrees) on the contra-lateral side can further reduce the need for a counter-traction perineal post. The pad may be sized to contact only a portion of the supported patient's body (e.g., lower back, buttocks) to generate lower levels of opposing force as required or desired for a particular application. Alternatively, the pad may extend the entire length of the supported patient's torso to generate increased levels of opposing force as may be required or desired for other applications.

3 FIG. 15 15 13 15 15 1 15 1 15 1 illustrates an exemplary friction padwhich can be used in one or more embodiments of the present technology. In accordance with various embodiments, the friction padmay fit over table extension. Friction padmay include a composite polymeric patient-contacting pad layer.that can be used to generate a coefficient of friction≥0.52 as measured between human skin and the surface of the pad.. For example, friction pad.may be a polymer-polymer or polymer-textile composite in various embodiments.

15 3 2 15 2 15 2 13 15 15 Additionally, an additional polymeric table-contacting layer.may be used in some embodiments to generate a coefficient of friction≥0.52 as measured between the pad and the abutting surface of the surgical table. The middle layer.of the padcan be designed to provide cushioning and support for the patient and to create a level surface between the surgical tableand the extension. The friction padmay be a disposable pad which can be thrown away at the end of each use. In some embodiments, the friction padmay be a disposable, sheet like covering for reusable surgical table cushions.

4 4 FIGS.A andB 15 15 15 13 2 15 15 15 are top views of other friction padsthat can be used in various embodiments of the present technology. In addition to the functions previously described for the friction pad, these embodiments of the friction padare designed to extend past the table extensionand cover all or part of the length of the surgical tableand provide restraint for the patient's arms during the procedure. The additional wrapping portions of the friction padsthat are used to assist in restraining the patient may include one or more apertures allowing access for fluid delivery or the like. As a result, one side of the friction padmay generate friction as the patient is positioned thereupon and the access material can be positioned (e.g., wrapped) around the patient to secure his hands or arms. The patterned material for wrapping and securing the arms of the patient may be the same or different material found on the rest of the friction pad (e.g., the portion that would be underneath the patient's back). In addition, friction padsmay be made of a flame resistant or flame retardant material.

5 FIG. 25 21 25 21 2 1 is a perspective view of a surgical tableand distraction systemaccording to another representative embodiment of the present technology. Tableand distraction systemmay be similarly constructed to tableand distraction systemdescribed in detail above, with like structures having like functions except as otherwise described below.

5 FIG. 1 FIG. 5 FIG. 1 FIG. 28 27 27 7 28 28 9 1 28 9 28 23 In the embodiment shown in, the support postshave been relocated from the embodiment shown in, to decouple the angular positioning (adduction and abduction) from the gross traction mechanism. Thus, in the embodiment of, gross traction mechanism(which operates similar to locking linear slidedescribed above) may be actuated without moving support posts. Support postsmay include fixed footers at their ground-contacting surfaces, rather than locking casters, of distraction system(), since postsneed not translate during distraction. Alternatively, locking castersmay be provided on poststo facilitate medial/lateral pivoting of beam members.

11 FIG. 5 FIG. 29 29 25 13 2 30 14 is an enlarged, partial perspective view of the table extensionshown in. Table extensionallows for positioning of the patient on the distal end of the surgical table, similar to table extensiondescribed in detail above with respect to surgical table. An optional perineal postmay be provided and designed to accommodate positioning for either right or left side procedures, similar to perineal postalso described in detail above.

23 23 27 Other embodiments of the present technology, while not pictured, can include a linear slide mechanism incorporated into the beam membersto minimize weight and size of the invention. In such an embodiment, a D-shaped, dovetail, or double dovetail profile for the beam members, with a locking clamp, may be used in place of gross traction mechanismto apply gross traction. Additionally, in some embodiments, a fine traction adjustment mechanism may be added using a linear/rotary motion conversion mechanism, such as a worm gear or a trapezoidal threaded rod (sometimes referred to as an acme rod) and correspondingly threaded rotary bushing. Such a fine adjustment assembly may be used, for example, to allow for a mechanical reduction such that movement of an input (e.g., a hand wheel or motor mandrel) is translated to a corresponding but reduced linear movement of the distal patient support.

6 FIG. 8 10 FIGS.- 6 FIG. 32 31 19 33 32 31 illustrates another conceptual representation of a perspective view of a surgical tableand distraction systemwith a telescoping linear slideon each of the beam membersaccording to one or more embodiments of the present technology.provide various perspective views of the surgical tableand the distraction systemintroduced in.

7 70 FIGS.A- 7 FIG.A 7 FIG.B 70 FIG. 35 37 39 33 32 are enlarged cross-sections of various linear slides mentioned above that may be used in various embodiments of the present technology. For example,illustrates a D-shaped slide profile;illustrates a dovetail slide profile; andillustrates a double dovetail slide profile. In some embodiments, an additional wheel type handle may be present in some embodiments to allow for fine traction adjustment, such as by linear/rotary motion conversion mechanism as discussed above. Other embodiments may include sliding features that may be electro-mechanically, pneumatically, or hydraulically adjustable (e.g., either actively or passively). Some embodiments may use a combination of sliding and controlled linear/rotary (e.g., acme rod) adjustment along beam membersto facilitate gross traction in patient on surgical table.

12 FIG. 1 FIG. 40 43 40 42 40 45 40 2 is an enlarged partial view of a representative embodiment of a base platformthat can be used in accordance with some embodiments of the present technology. The beammay allow for length adjustments near base platformusing a pin system (e.g., clevis pins)that join nested or telescoping tubing segments in various discrete length-adjustment configurations. The base platformmay also include locking/leveling castersfor support and adjustment of base platformrelative to, or in conjunction with, the surgical table (e.g., surgical tableshown in).

13 FIG. 1 FIG. 5 FIG. 47 7 47 12 47 24 8 10 is an enlarged partial perspective view of a sliding mechanismthat can be used in various embodiments of the present technology. The sliding mechanism can provide linear gross traction and/or fine traction and can be used in conjunction with any of the distraction system described herein to provide for linear movement. Similar to locking linear slidesdescribed above with respect to, sliding mechanismmay be actuated to move mount(and/or any attached or other distal patient restraint) towards or away from the surgical table to reduce or increase traction, respectively. Sliding mechanismcan be locked in position with locking clamp. In the illustrated embodiment, support posts or stanchionsin conjunction with gearboxallow for vertical adjustment of equipment though other arrangements may be used (e.g., the arrangement of).

14 FIG. 15 FIG. 1 FIG. 14 FIG. 15 FIG. 15 2 15 15 μ μ T μ T is a schematic representation illustrating how various friction calculations can be made when a patient is in a declined position on a surgical table with the distraction system that can be used in one or more embodiments of the present technology.is a chart illustrating coefficient of friction calculations based on an angle θ for various weights (i.e., the weight of a patient or a portion of a patient received on a patient support surface, as described herein, is the product of the mass m of the patient or portion of the patient and gravity g). The friction padillustrated incan be selected to adjust the friction coefficient. As a result, the patient resting upon the patient support surface of surgical tablecan be placed in a tilted position at a desired angle θ. This combination of tilting and friction generates a force F, which is a function of the Trendelenburg angle θ, the mass m of the patient, and the coefficient of friction μ of the friction padas detailed in. For a given patient mass m, the Trendelenburg angle θ and the coefficient of friction p can be selected to provide a desired force Fto sufficiently counteract the required or desired traction force F, which acts directly opposite force Fas shown. These counteracting forces will keep the patient in place while allowing the surgeon to generate enough traction force Fon the leg of the patient to gain access to the central hip joint compartment of the patient without the use of a perineal post or to minimize pressure between the patient and a perineal post for configurations including a perineal post is used. In some embodiments, the angle θ can vary in the range from about 0 degrees to about 25 degrees, while the coefficient of friction μ may also be varied together with the area of contact between the patient and the friction padin order to generate the necessary counteracting forces. Various combinations and permutations of these variable factors are illustrated in the tables ofto provide a sampling of potentially viable combinations based on patient weight.

16 FIG. 16 FIG. 50 50 15 is an isometric view of a friction padthat can be used in some embodiments of the present technology. The friction padillustrated indoes not include a cutout for a perineal post, though such a cutout may be provided as described above with respect to friction pad.

17 FIG. 14 FIG. 52 52 50 50 52 μ is a partial perspective view of a friction pad materialthat can be used in one or more embodiments of the present technology. As illustrated, a series of angled ridges may be provided in the patient-support surface of pad material. In one embodiment, these ridges may be oriented to point generally opposite the direction of force F() when friction padis in use, such that a compressive force is placed on the ridges. Each ridge may therefore resiliently deform when the patient is resting on pad, presenting a barrier to sliding movement of the patient, upon the patient support surface, effectively increasing the coefficient of friction p of the pad material.

18 FIG. 1 FIG. 54 56 56 7 58 60 is an isometric view of a surgical table, distraction system, and various accessories in accordance with one or more embodiments of the present technology. Distraction systemis arranged similar to distraction systemshown inand described in detail above, except that the linear bearingsand support postsare differently arranged as described further below.

19 FIG. 18 FIG. 19 FIG. 58 56 58 58 60 is an isometric view of the dual linear bearingused in distraction systemintroduced in. As illustrated, dual linear bearinguses one bearing along the bottom of the linear slide, and a second bearing along the top of the linear slide. The bottom and top bearings may be independently adjustable. The dual linear bearings(slides) illustrated incan be used in some embodiments to enhance support of the transverse loads on the support posts.

20 FIG. 20 FIG. 64 62 56 62 56 64 62 illustrates hingesin an arm or beamof a distraction systemin accordance with one or more embodiments of the present technology. In the embodiments illustrated in, the armsof the distraction systeminclude hingesto adjust the angle of the armwith respect to the floor. This feature may allow for a better fit of the system to an individual patient.

21 FIG. 21 FIG. 60 56 60 58 illustrates a telescoping support postof a distraction systemthat can be used in accordance with one or more embodiments of the present technology. As illustrated in, the support postsabove and below the linear bearings(slide) include a telescoping feature which also helps fit the system to an individual patient.

22 FIG. 68 56 68 56 illustrates a leveling casterof a distraction systemin accordance with one or more embodiments of the present technology. The leveling casterscan be used to ensure the distraction systemmaintains equal contact with the floor under all loading scenarios.

23 FIG. 56 62 60 56 is a side view of a distraction systemwith carbon fiber components in accordance with one or more embodiments of the present technology. In some embodiments, the beams, support posts, and/or other components may be made of carbon fiber. Carbon fiber tubing can replace aluminum tubing in order to produce a lighter, stronger, and stiffer distraction system.

24 FIG. 24 FIG. 66 70 70 70 illustrates an end post assemblyof a distraction system in accordance with another embodiment of the present technology. The support of the linear bearingis shifted to an ‘end-post’ design in order to allow for a single sliding surface on linear bearingwhen pulling traction. As illustrated in, the end post design can support the weight of the distraction system independent from sliding surface of bearing.

25 FIG. 72 74 62 62 illustrates a locking stability mechanismof a distraction system that can be used in accordance with one or more embodiments of the present technology. The handleshown is configured to lock the armin a desired adduction degree configuration, limiting or eliminating the freedom of armto move when so locked. This locking can be used to improve stability of the distraction system.

26 FIG. 26 FIG. 76 78 78 80 12 80 78 81 76 is an isometric view of an alternate distraction systemusing a lower fixed railand fixed geometry for the distraction system in accordance with one or more embodiments of the present technology. The alternate frame design illustrated inprovides for a lower a railcloser to the ground. In some embodiments, the frame may be made out of machined aluminum. The rail components may be fixed in length and geometry. The postis telescoping in order to adjust the height of mount(and/or any attached or other distal patient restraint). The degrees of abduction may be varied but no locking mechanism is required. Traction may be achieved by sliding the postalong the rail, and may be locked in place by actuation of locking handles. Distraction systemis shown attached to a surgical table, and may be used in conjunction with any suitable surgical table as described herein with respect to other embodiments of the present technology.

27 FIG. 12 FIG. 25 FIG. 82 84 82 84 82 84 88 84 86 74 82 illustrates telescoping horizontal beamusing a clevis pinsimilar to that described above with respect to. A telescoping horizontal beamusing a clevis pinwhich allows for adjusted length of the frame with respect to the surgical table. The beamcan be adjusted among various discrete length configurations by moving clevis pinbetween a plurality of adjustment apertures. In some embodiments, the clevis pinis retained in position with a cotter pin. Locking handle, described above with respect to, may also be provided to lock the adduction angle of beam.

28 FIG. 90 90 92 94 96 98 96 92 98 96 94 101 96 100 102 96 90 is an isometric view of a distraction systemin accordance with another representative embodiment of the present technology. The distraction systemintegrates roller bearingsinto the abduction jointand uses a single steel square arm tubeto mount the rail. Each armrotates about an associated vertically oriented axis corresponding to the axis of bearing, to provide for hip adduction and abduction of a patient's leg. The railis mounted to the top portion of the square tubeto allow for gross traction. The jointis located at a proximal endof armand a caster and leveling foot assemblysupports the distal endof the square tube. Distraction systemis shown attached to a surgical table, and may be used in conjunction with any suitable surgical table as described herein with respect to other embodiments of the present technology

29 FIG. 30 FIG. 104 106 90 108 110 108 104 112 106 108 114 116 104 110 108 104 108 illustrates an anchoring bracketthat can be used to secure a baseof the distraction systemto a surgical tablein accordance with one or more embodiments of the present technology. The feetof the surgical tablesecure the bracketto the floor; then leveling screwscause compression between baseand the surgical table. Horizontal and vertical slotsand, respectively, allow the bracketto be maneuvered under the feetof the surgical tableand/or lifted off the ground when the table is rolling or otherwise being repositioned. Bracketis also shown attached to tablein.

30 FIG. 94 92 92 94 96 92 illustrates an abduction jointwith integrated roller bearingin accordance with one or mare embodiments of the present technology. The roller bearingis integrated into the abduction jointin order to allow for smooth motion and to prevent torsional loads from deflecting the arm. The bearingwithstands the lifting moment produced when the patient's leg is in traction and therefore maintains the stability of the frame.

31 FIG. 28 FIG. 100 90 120 122 96 122 125 124 illustrates the caster and leveling foot assemblyof the distraction system() that can be used in accordance with one or more embodiments of the present technology. A casterand leveling footprovide for both motion of the armabout the abduction joint and also stability when the leveling footis lowered by actuation of jack screwvia adjuster knob.

Methods related to distracting the hip joint are also disclosed, such as a method for distracting the hip joint where the force resisting the distraction force is applied not through the use of a perineal post but through a combination of: 1) tilting the patient backward at an angle between 2 degrees and 20 degrees from the horizontal; and 2) placing fabric or material that produces increased frictional resistance between the patient's back and the underlying

In an embodiment, a method for distracting a patient's hip joint includes applying a distraction force to the patient's leg and resisting the distraction force without the use of a perineal post. The resisting can include tilting the patient backward on a support surface relative to the patient's leg at an angle between 2 degrees and 20 degrees from horizontal and placing a friction increasing material between the patient and the support surface. In some embodiments, the method further comprises tilting the support surface to a contra-lateral side relative to the patient's leg at an angle between 0.5 and 2 degrees from horizontal.

In another representative embodiment, a method of configuring a surgical table as a distraction system includes attaching a distraction system base to a base portion of the surgical table and rotatably coupling a pair of arms to the distraction system base. The method can also include attaching a table extension to a table portion of the surgical table and positioning a friction pad on the table extension. In some embodiments, the table portion is tilted away from the distraction system base at an angle between 2 degrees and 20 degrees from horizontal. In some embodiments, each arm rotates about an associated vertically oriented axis. In some embodiments, the method includes connecting an upwardly extending support post to each of the pair of arms and/or tilting the table portion toward a lateral side of the surgical table at an angle between 0.5 and 2 degrees from horizontal.

The above description and drawings are illustrative and are not to be construed as limiting. Numerous specific details are described to provide a thorough understanding of the disclosure. However, in some instances, well-known details are not described in order to avoid obscuring the description. Further, various modifications may be made without deviating from the scope of the embodiments. Accordingly, the embodiments are not limited except as by the appended claims.

Reference in this specification to “one embodiment” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the disclosure. The appearances of the phrase “in one embodiment” in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. Moreover, various features are described which may be exhibited by some embodiments and not by others. Similarly, various requirements are described which may be requirements for some embodiments but not for other embodiments. The features of the various embodiments of the present technology disclosed herein may be used in any combination or permutation, unless explicitly specified otherwise. For example, various linear-motion devices shown and described in the present disclosure may be utilized in any combination at the various linear-motion junctions between structures, as required or desired for any particular application of the present technology.

The terms used in this specification generally have their ordinary meanings in the art, within the context of the disclosure, and in the specific context where each term is used. It will be appreciated that the same thing can be said in more than one way. Consequently, alternative language and synonyms may be used for any one or more of the terms discussed herein, and any special significance is not to be placed upon whether or not a term is elaborated or discussed herein. Synonyms for some terms are provided. A recital of one or more synonyms does not exclude the use of other synonyms. The use of examples anywhere in this specification, including examples of any term discussed herein, is illustrative only and is not intended to further limit the scope and meaning of the disclosure or of any exemplified term. Likewise, the disclosure is not limited to various embodiments given in this specification. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure pertains. In the case of conflict, the present document, including definitions, will control.